Small bowel perforation following blunt abdominal trauma caused by an accidental hammer blow: A case report

Introduction. Trauma is among the leading causes of death. Undetected and untreated adequately and on time, traumatic small bowel injuries can be lethal. Case Report. We present a case of a small bowel perforation after a blunt abdominal injury, caused by an accidental self-inflicted hammer blow to the abdomen. The initial abdominal and chest x-rays and abdominal ultrasound did not indicate an injury to the abdominal organs. Due to the impaired clinical picture and the fact that the patient was hemodynamically stable, multi-detector computed tomography of the abdomen and small pelvis was performed, showing intraperitoneal free fluid and pneumoperitoneum, not seen by other imaging methods. A decision for surgical treatment was made. The intraoperative finding confirmed a small bowel perforation. Conclusion. Due to the possible false-negative imaging findings, clinical follow-up of patients with abdominal trauma is mandatory when making the decision for surgical treatment.

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Delayed small bowel perforation following blunt abdominal trauma: A case report and review of the literature

Asian Journal of Surgery ◽

10.1016/j.asjsur.2013.01.006 ◽

2016 ◽

Vol 39 (2) ◽

pp. 109-112 ◽

Cited By ~ 10

Author(s):

Alireza Hamidian Jahromi ◽

Lester Johnson ◽

Asser M. Youssef

Keyword(s):

Case Report ◽

Small Bowel ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Bowel Perforation ◽

Small Bowel Perforation ◽

Review Of The Literature

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Isolated Small Bowel Perforation Following Blunt Trauma

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v18i1.799 ◽

2019 ◽

Vol 18 (1) ◽

Author(s):

G Dhayalan ◽

AH Junaidi ◽

MS Salleh ◽

K Aina

Keyword(s):

Small Bowel ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Bowel Perforation ◽

Abdominal Injury ◽

Organ Injury ◽

Free Fluid ◽

Solid Organ ◽

Small Bowel Perforation ◽

Left Femur

Small bowel perforation is common following blunt abdominal trauma. Intra-abdominal injury with isolated small bowel perforation however, is a rare entity and diagnosis can be ambiguous. Nonisolated small bowel perforation, which carries a higher mortality rate, will be identified early during the assessment of the patient following a blunt abdominal trauma. A case of an isolated small bowel perforation following a road traffic accident is reported. A motorcycle rider, while trying to avoid a car, lost control and skidded into a drain. Upon arrival to the Emergency Department, he was complaining of upper abdominal pain evident by abrasion and bruising of his bilateral hypochondriacs. FAST scan showed free fluid at Morrison’s pouch and a formal abdominal ultrasound confirmed minimal free fluid at Morrison’s pouch. A plain CT abdomen was done and did not show any evidence of solid organ injury but demonstrated pneumoperitoneum. In view of the persistent abdominal tenderness, open fracture of left femur, radius and ulna, and radiological findings, a laparotomy was performed which revealed an isolated 1x1cm small bowel perforation, 60cm from DJ junction with localized faecal contamination. Small bowel repair was done and patient recovered well afterward. Although challenging, due to its detrimental infectious potential, early recognition of small bowel injury is crucial. Isolated small bowel perforation, rarely without associated intra-abdominal injury, requires more investigations, delaying diagnosis to treatment period. CT abdomen has proven to be both specific and sensitive in diagnosing small bowel injuries. Even when physical examination and radiological examinations are minimal, a suspicion of small bowel perforation should be considered as delay in diagnosis eventually increases morbidity and mortality.

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Parasitic leiomyoma causing small bowel perforation: A case report

Case Reports in Women s Health ◽

10.1016/j.crwh.2021.e00349 ◽

2021 ◽

pp. e00349

Author(s):

Anya Laibangyang ◽

Cassandra Law ◽

Gunjan Gupta ◽

Xiang Da Dong ◽

Linus Chuang

Keyword(s):

Case Report ◽

Small Bowel ◽

Bowel Perforation ◽

Small Bowel Perforation

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Case report: reinitiating pembrolizumab treatment after small bowel perforation

BMC Cancer ◽

10.1186/s12885-019-5577-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Tim N. Beck ◽

Alexander E. Kudinov ◽

Essel Dulaimi ◽

Yanis Boumber

Keyword(s):

Case Report ◽

Small Bowel ◽

Bowel Perforation ◽

Small Bowel Perforation

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A Small Bowel Perforation in a Goalkeeper: A Case Report and Return to Play Progression

Journal of Athletic Training ◽

10.4085/261-20 ◽

2021 ◽

Author(s):

Kenzie Johnston ◽

Tara A. Condon ◽

Mario Ciocca ◽

Alain Aguilar

Keyword(s):

Case Report ◽

Small Bowel ◽

Primary Repair ◽

Bowel Perforation ◽

Return To Sport ◽

Return To Play ◽

Small Bowel Perforation ◽

Unique Challenge ◽

Surgical Interventions ◽

High Level

Abstract Sports-related intra-abdominal injuries are rare and may be associated with significant morbidity if missed. We present the case of a 21-year-old male collegiate goalkeeper who suffered a small bowel perforation in practice after colliding with a teammate. This athlete underwent laparoscopic primary repair of his small bowel perforation, a relatively uncommon type of surgical intervention for this injury given that similar patients are typically treated via laparotomy. Due to rarity of small intestine injuries in sport, information regarding the success of surgical interventions and return to play (RTP) standards are lacking, let alone information on outcomes and return to sport following a laparoscopic repair. In this case report, we discuss the unique challenge of constructing a RTP protocol for this high-level athlete and propose a protocol for RTP following intra-abdominal injury treated laparoscopically.

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